CKids Chanukah 2022 Parent/Guardian InformationParent/Guardian Name* First Last Email* Cell Phone*Address* Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Number of Children RegisteringOneTwoThreeFourChild 1 Information:Child Name* First Last AgeChild 1 Attending: Tie Dye Chanukah Child 2 Information:Child Name* First Last AgeChild 2 Attending: Tie Dye Chanukah Child 3 Information:Child Name* First Last AgeChild 3 Attending: Tie Dye Chanukah Child 4 Information:Child Name* First Last Child 4 Attending: Tie Dye Chanukah AgeParent Participation I will be attending with my child(ren) My child(ren) I will be attending alone Total $0.00 Credit CardCard Details Cardholder Name
